Update 18 November 2025

Welcome back to another update on the Dutch commercial healthcare market. The process related to agreeing a new coalition government has started and hopefully it will be finished by Christmas (2026). When there is any news to provide, we will certainly let you know. Luckily, there is other news related to the Dutch healthcare sector. In this update we cover:

• Acibadem opens new clinic in Rotterdam. What is their history in the Dutch market?
• Novicare deal approved by ACM. What are the next steps?
• Dutch hospice care needs revamp. What is the situation?
• New financing system for ER care from 2027. What will it look like?

Acibadem opens new clinic in Rotterdam

Acibadem is a large Turkish hospital chain that is active in eighteen countries with twenty-nine hospitals and 15 medical centers. They entered the Dutch market in 2017 with a greenfield hospital in Amsterdam. This was something that was mentioned in the first-ever update that I sent out. Since then it has been quiet concerning Acibadem’s activities in the Dutch market. Last week they announced that they are going to open a new “hospital” in Rotterdam in February. Acibadem’s goal is to provide high-quality, insured care that is accessible without long waiting lists. The focus in Rotterdam will be orthopedic care, spinal surgery, and radiology. The new location will provide diagnostics, outpatient care, and surgery.

Novicare deal approved by ACM

In our update at the beginning of September we briefly explained that GIMV was acquiring Novicare. Recently it was announced that the Dutch Authority for Consumers and Markets (ACM) has approved the acquisition. Novicare is an interesting company that focuses on providing medical staff to long-term care providers (elderly care and disabled care). They are different from similar companies because Novicare does not provide temp-staff, but rather enters into long-term contracts where the customer essentially outsources all or parts of its treatment-related activities to Novicare. Novicare currently has 250 professional staff that provide treatment-related care in seventy long-term care facilities to 4.500 patients.

Dutch hospice care needs revamp

Due to demographics there is a growing need for hospice care in the Netherlands. However, the sector exists in a grey zone with unclear financing and many organizations run by volunteers. Gupta Strategists have recently developed a structured overview of the sector and made recommendations for how to modernize financing and organizational issues in order to improve the sector. Gupta believes that there are currently more than 240 hospices in the Netherlands and that the total costs of the sector are approximately €280 million.

The key recommendation from the Gupta report is to divide the sector into two separate parts. One part of the sector is for clients in need of 24/7 professional healthcare. The other part of the sector is for clients that cannot die at home but do not need intensive care. Gupta suggests that the first category of hospices should be seen as formal healthcare providers and be financed by the healthcare insurance companies. The second category should be seen as part of the social domain and be financed by local government (municipalities).

Gupta Strategists believe that there will be a need for between 200-450 new hospice beds in the coming years. It has also suggested a time-plan of five to seven years for implementing the suggested changes. It will be interesting to see how active a role the Ministry of Health takes in following up on these recommendations, and what the possible consequences are for commercial providers of end-of-life care in a home setting such as Attenza.

New financing system for ER care from 2027

In the Netherlands, all healthcare activities conducted by hospitals are currently paid by activity-related codes (DBC – Diagnostic Treatment Combination). A DBC covers all the activities carried out by a hospital for diagnosing and treating an individual patient, resulting in a purely volume-based payment model. This works reasonably well for most activities (although a new model was developed for psychiatric care a few years back). The model has not worked well for Emergency Rooms (ER) where patients come in requiring immediate unplanned care and where the costs for providing the required care has few links to the actual volume of care (given the need for the ER to be available 24/7 and with large differences between low demand and peak demand).

Dutch regional hospitals are facing financial challenges as healthcare activities are moved to a home setting or specialized clinics. It has therefore been decided to develop a new financing system for ERs. Basically the new system entails that ERs that are open 24/7 will get a fixed payment. ERs that are sometimes closed will get a proportionally lower fixed payment. However, the ER will still need to invoice individual patient visits, but the tariff will be different for each ER depending on the number of patients for the individual ER. The new system is meant to ensure that existing ERs stay open, but will not provide additional financing for hospitals / ERs that are already in the process of closing.